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General NPI Number Information
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NPI Number | 1497624779
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Entity Type | Organization
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Legal Business Name | FOUR LUCKY KIDS, LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1225 RAINTREE PL
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City | WINTER PARK
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State | FL
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Zip | 32789-2565
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Country | US
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Telephone | 407-865-4074
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Fax | 407-812-9906
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Provider Business Mailing Address
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Address Line | 1225 RAINTREE PL
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City | WINTER PARK
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State | FL
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Zip | 32789-2565
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Country | US
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Telephone | 407-865-4075
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Fax | 407-812-9906
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Authorized Official
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Title or Position | OWN/PHYSICIAN
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Name | DR. WILLIAM D PATTEN
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Credential | MD
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Telephone | 407-865-4075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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